We Asked Infectious Disease Experts to Rank 5 Flu-Prevention Products

If you’ve ever had the flu,
you know it can take you out like a wrecking ball, Miley Cyrus–style.
So we can’t blame anyone for wanting to buy out the entire cold and flu
aisle at the drugstore—including absolutely anything that claims to
boost your immune system or protect you from the flu. But...do any of
them really work?

“The problem with most of
these products is that there is little scientific evidence to support or
refute their claims, so it basically comes down to [people's
opinions],” Richard Watkins, M.D., an infectious disease physician in
Akron, Ohio, tells SELF.

So we consulted Dr. Watkins and other infectious disease experts to get their take on which products are helpful, which ones might
work, and which ones have little to no science proving that they’ll
help you avoid the flu. Read this before you put all your faith in them.

2. Helpful: hand sanitizers

Along with getting a flu
shot, hand hygiene is incredibly important. The flu spreads through
little airborne droplets people produce when they talk, cough, or
sneeze, according to the CDC.
You can either inhale those droplets, or they can land on surfaces on
which you can touch them and put them in your mouth or nose. If you
regularly clean your hands, it lowers the risk that those germs will
actually make it inside your body and give you the flu.While
washing your hands with soap and water is ideal, using your
garden-variety hand sanitizer can also be helpful if you’re not near a
bathroom, Amesh A. Adalja, M.D., senior scholar at the John's Hopkins
Center for Health Security, tells SELF. The CDC recommends using a version with at least 60 percent alcohol, since that's the most effective at killing germs.

3. May be helpful: wearing a face mask or shield

The CDC
says it’s a good idea for medical practitioners to wear either a face
mask along with eye protection or a face shield when dealing with flu
patients. (This is why doctors and nurses often use them.) But there are also face masks and shields for other people who are looking for protection.

“Much
like hand washing and proper sneeze etiquette, wearing our masks...can
help to prevent transmission of the flu virus,” Mike Vahey, a
spokesperson for Breathe Healthy, tells SELF. Vahey says that these
kinds of masks can protect the person wearing them by filtering out
germs that could cause the flu, and they may also protect others by containing the flu virus. (Uline and Medicus Health did not return SELF’s request for comment.)

According
to the experts we spoke with, wearing a face mask or shield can
actually be a great idea for specific people in specific situations—such
as if you are caring for someone with the flu. “It could potentially
help keep you healthy,” William Schaffner, M.D., an infectious disease
specialist and professor at the Vanderbilt University School of
Medicine, tells SELF. It could also help protect them (or other
immunocompromised people, like those having chemotherapy) from your own
germs, Dr. Adalja says.

But for otherwise
everyday use, it’s probably not worth the effort. These products only
work well if you use them properly, Dr. Adalja says, and that actually
amounts to a fair bit of work. You’d basically need to wear one all the
time while in public or exposed to other people. You’d also need to wash
your hands well before putting the mask or shield on and after taking
it off, Dr. Schaffner says. (And remember, removing the mask or shield
around other people makes it less effective.)

If
you were to opt for a reusable mask, you’d need to wash it after every
wear, Dr. Adalja says. Unless you’re the rare laundry fanatic, that
doesn’t sound doable. Also, washing the mask that frequently could lead
to wear and tear, making it less likely to fit the way it should.
Ultimately, this could expose you to the very germs you’re trying to
avoid, Dr. Schaffner says.

4. Probably not helpful: vitamin C–based immune support supplements

Most people consider vitamin C the gold standard for preventing pretty much every illness, including the flu. That’s why products packed with vitamin C, like Airborne, Emergen-C, and SufficientC have become so popular.

It’s
worth noting that each of these products have disclaimers on their
websites saying they’re actually not intended to prevent disease. That’s
a good thing, because evidence to support their flu-fighting properties
doesn’t really exist.

A 2013 review of scientific literature published in the Cochrane Database of Systematic Reviews
looked at 29 clinical trials on colds and vitamin C usage involving
11,306 people. The researchers found that although taking vitamin C
won’t prevent people from getting a cold,
there’s a chance it could improve some people’s cold symptoms. But
that’s for the cold, not the flu, and they’re caused by two different
types of viruses.

Most colds are transmited by a type of rhinovirus, according to the Mayo Clinic. Influenza viruses,
which cause the flu, are completely different, and unfortunately
there’s zero data that says vitamin C can prevent them from infecting
you.

Proponents say vitamin C might help you battle oxidative stress,
a process triggered by infections and which can lead to cell damage.
“All infections produce increased oxidative stress and rapidly deplete
the body of vitamin C. This is why taking higher doses of vitamin C,
like those found in Sufficient-C, can restore what is lost,” Caralyn
Vessal, founder and creator of Sufficient-C, tells SELF. To be clear,
Vessal isn’t saying that her product can prevent colds or the flu, just
that there could be some benefit to having more vitamin C when your body
is fighting off an infection. (Airborne and Emergen-C did not return
SELF’s request for comment.)

Oxidative stress
does take place during an infection as your body’s immune system tries
to keep you healthy, Dr. Adalja explains. Certain molecules in your body
try to “mop up” oxidative stress, and vitamin C is one of them, he
says. However, when you’re talking about a relatively mild illness like
the common cold or a typical case of the flu, your body can rebound with
no problem—and no extra supplementation, Dr. Adalja says.

Also,
while it may sound impressive that these kinds of products provide
upwards of 1,000 milligrams of vitamin C, adults only need around 75 to
90 milligrams of the stuff per day, according to the National Institutes of Health. You usually just pee out what you don’t need, Dr. Schaffner says, so taking a ton likely won’t help your cause.

While
vitamin C is the major ingredient in these kinds of supplements, they
usually contain others purported to help boost your immunity too. Vessal
says additional ingredients in her product, like the amino acid L-lysine (which she calls a “virus annihilator”), bromelain (a mix of pineapple plant enzymes that may help with inflammation), and green tea extract (an antioxidant), also can help.

There
isn’t much valid scientific evidence to support L-lysine and
bromelain’s flu-busting abilities, Dr. Adalja says. And research to
support green tea’s benefits for flu prevention has been mixed. One
randomized, double-blind, placebo-controlled study of 200 healthcare
workers published in BMC Complementary Alternative Medicine
found that people who took green tea catechins (the major components of
green tea extract) and theanine (an amino acid in green tea) were less
likely to get the flu than those who took the placebo. Specifically,
four people who took the green tea pills got the flu, compared to 13
people in the placebo group. However, this was a pretty small study.

Another study published in the journal PLOS One
looked at 757 high school students who gargled green tea three times a
day, finding that the practice was no more effective at preventing the
flu than people who did the same thing with water.

Overall,
Dr. Adalja says that you’re not likely to see a huge flu-prevention
benefit from drinking green tea—or taking these kinds of supplements in
general—but that it also won’t hurt you, either.

5. Probably not helpful: Reusable airplane seat covers

Flying
in an airplane basically means you’re marinating in a tin can full of
other people’s germs. If one of those passengers has the flu, it
increases the odds that you could breathe in illness-causing droplets,
Dr. Schaffner explains. There’s also a chance that flu germs could get
on commonly used surfaces.

Enter Seat Sitters reusable airplane seat covers.
These covers go over your plane seat to protect you from “one of the
dirtiest surfaces in air travel—the chair upholstery,” according to the
product’s website. A press release from the company also promises that
the covers, which each come with a tray table cover, two sanitizing
wipes, and a face mask, will help you “fly flu free!”

“The
logic eludes me,” Dr. Schaffner says. “These are respiratory
infections. What’s a seat cover going to do? The virus doesn’t hang out
in the fabric waiting to bite you in the fanny.”

It
makes sense that if there are flu germs on the seat, putting a barrier
between it and you could stop you from touching them and then bringing
them to your face. But this is like putting a tiny bandage on an
airplane-sized injury. “It’s probably a little overkill,” Dr. Adalja
says. “When you’re on an airplane, you’re going to be touching more
things like bathroom door handles that make you more likely to get the
flu.” You’ll also probably be touching the armrests a lot, and these
seat covers don’t hide those—though covering the germy tray table can be
a good idea.

Still, your biggest risk of contracting the flu
on a plane is from someone who is seated near you and is coughing,
sneezing, or otherwise ejecting influenza-filled droplets on or near
you, Dr. Schaffner says. Unfortunately, this seat cover isn’t going to
help in those situations. (Seat Sitters did not return SELF’s request
for comment.)

Of course, the product couldn’t
hurt if it’s something that appeals to you—though you’ll probably have
to deal with fellow passengers’ questions about what on earth you’re
doing with that seat cover. But if you’re really trying to avoid picking
up germs on a plane, you’re probably better off bringing some
sanitizing wipes to clean the armrest, tray table, and seat back in
front of you. Some hand sanitizer you can use after touching bathroom
door handles wouldn’t hurt, either.

Technophobe comment: Not all hand sanitisers are created equal, read the label and not all suppliaments are made the same either, vitamin D is the best immune booster, A, C nd Zinc help too The whole lot work synergestically.

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